Posted by hrguru on May 11, 2010, at 16:14:40
In reply to Re: Need strongest stimulant suggestions » hrguru, posted by juanantoniod on May 11, 2010, at 13:40:10
Hi there,
I probably didn't state that very well (regarding Subutex). I should have explained that I am an ex-opiate addict (though I have completed recovery and have been opiate-free for almost a year and a half). My Pdoc uses Subutex for recovering addicts, so I am just not familiar with its use for TRD. Although I have known others who have taken Subutex, I have never taken it myself. But you have- so you know that it is effective for TRD, because it's worked for you. To be honest, I'm not the best person to give an opinion on this because I don't know what Subutex feels like in the system. However, I do believe there are certain cases (as in yours) where people fit the profile to be treated w/ Subutex for TRD. I would probably NOT fit the profile, even if I had TRD, as I (to be blunt) have had major issues with opiates (no other meds, just opiates for some reason). I would probably even have problems with a partial opiate-blocker like Subutex. So for some it works, some it doesn't. In any case, I am SO happy you've found something that works for you!! :)
I am almost thinking that my mom's Psych-NP colleague will likely suggest Vyvanse, but I can't be too sure. I will have to of course, tell her your medical conditions first.
I can tell you one thing that helps me though, to keep my Adderall (I take instant release) working effectively. I don't know if this advice will help or not, but if I feel myself building-up a tolerance, I will decrease the dosage (just a little) the next day (or for a couple of days), and then go back to the regular dose the day after that. You can play around with it the dose a little (my doc's words), as long as (of course) you're not increasing the max dose. Here's an example of what I might do: I am prescribed to take 20mg. twice per day. So one day I might take a morning dose of 20 mg. and an afternoon dose of 10mg. Or each dose might be 10mg. Sometimes I do this for up to a week, decreasing the dose on certain days. Then I go back to my regular dose, and I will notice its effectiveness again. This has kept me from taking more than I am prescribed to take, and has kept me from becoming tolerant- while maintaining the effectiveness of the med.
You and I take stimulants for different medical conditions and to achieve different effects, so I don't know if this is advice you can use, but it has helped me. Just thought I would mention it.
And I will get back to you with any info I can find :)
HRGuru
Dx: BPII w/rapid cycling, ADHD, OCD, specific phobia *all controlled*; substance addiction *full recovery >1year*
Rx: Topamax, Adderall, WellbutrinSR, Omega3 [Klonopin & Lunesta as needed]
poster:hrguru
thread:947032
URL: http://www.dr-bob.org/babble/20100504/msgs/947128.html